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Work in Medicine—as Context, Disease, and Cure

January 5, 2024 - 3:48pm by Melissa Grafe

Written by Jiemin Tina Wei, Ferenc Gyorgyey/Stanley Simbonis YSM’57 Research Travel Grant recipient, 2023-2024 December 29, 2023 What is the relationship between work and medicine? It may seem obvious, especially amidst this year’s wave of unionization of medical residents, that medicine is a form of work. But just as medicine can be work, work can be (and has been, in certain historical moments) medicine. My dissertation and book in progress, “Ameliorating Fatigue at Work: Workplace-Management, Mind-Body Medicine, and Self-Help for Industrial Fatigue in the U.S., 1900-1950,” investigates the history of attempts to ameliorate workplace fatigue in the first half of the twentieth century. It traces how scientists from industrial medicine, occupational health, physiology, ergonomics, industrial psychology, psychiatry, psychoanalysis, and economics struggled to and succeeded in making work and workers into objects of scientific study. For the scientists I study, labor dynamics gave context to their discoveries—providing the backdrop, for instance, to their gendered division of labor, as well as their differential compensation and recognition of work done by women. Focusing on the labor dynamics implicit in the production of science resonates with recent calls by scholars to study “a labor history of science.” A group of historical subjects that I study, clustered around the social networks of physician E.E. Southard, first Director of the Boston Psychopathic Hospital prior to his death in 1920, was interested in this problem in its inverse—looking not at how labor can yield insights into science, but how at how science can yield insights into labor. These psychiatrists and psychiatric social workers collected data and biological material from their mental hospital patients to study the neurological and psychopathic roots of myriad workplace dysfunction, such as refusal to work and tendency to unionize. Oriented, as many of them were, around the eugenics movement, they aimed to socially rehabilitate patients they classified variously as feebleminded, insane, nervous, and psychopathic. Refitting as many individuals as possible to productive work, they sought to resolve the growing social problem of their time, militant labor uprisings. In their medical practice, work was part of disease and cure. Through the generous support of the Ferenc Gyorgyey/Stanley Simbonis YSM’57 Research Travel Grant, my dissertation took me to the Medical Historical Library in the Harvey Cushing/John Hay Whitney Medical Library at Yale University. My visit focused on the collections of the esteemed neurosurgeon Harvey Cushing, a namesake of the Library. Cushing and his colleague and assistant, pathologist Louise Eisenhardt, were collaborators of Southard and his colleague and assistant, pathologist M.M. Canavan. Due to limitations of surviving materials about Southard and Canavan, Cushing and Eisenhardt’s repositories provide a crucial point of contrast and help populate modern scholarship with details about the social-professional world of these physicians. The gems of this collection give material reality to this cohort’s medical work. Cushing, a draftsman in addition to a surgeon, littered his Harvard Medical School lecture notebooks with drawings, leaving behind a kind of illustrated textbook of early-twentieth-century medical education. See for instance, his sketches for a lecture on the kidney.­ Left: Harvey Williams Cushing Papers, Histology and Embryology, 1891-92, H.M.S., pp 13a-b. The Robert Bogdan Disability Collection also held striking visual material documenting the life of workers and patients at state mental hospitals and related institutions. Among the collection’s fifteen enormous three-ringed photo albums, Book 6 features postcards and other images from "Institutions: Insane, Feeble minded, Epileptic, Deaf, Blind, ca. 1900-1930." At the State Hospital in Gowanda, N.Y., for instance, postcards show the kitchen, laundry, operating room, superintendent’s residence, staff house, and nurses house.   Above: Assorted photos from State Hospital, Gowanda, N.Y. From the Bogdan Disability Collection, Book 6. Other photos showed “Breaking of Ground for Assembly Building” at the New Jersey State Village for Epileptics at Skillman; Field Day at State Hospital in Willard, NY; and dining rooms in the Massachusetts Hospital in Palmer, MA, and at the State Hospital in North Warren, PA. Above: Assorted photos from the Bogdan Disability Collection, Book 6. Numerous images showed nurses in posed group photos and while recreating, such as at the Asylum in Middletown, NY, and the State Hospital in Gowanda, NY. Above: Front and back of postcard, Middletown, NY, Asylum Above: Assorted photos from the Bogdan Disability Collection, Book 6. The postcards even featured several institutions dedicated to vocational rehabilitation in the U.S. and abroad, such as the State Industrial School for Girls in Mitchellville, IA. These photos, one of which appears to be taken by “Richard the Druggist,” shows these so-called troubled girls gathering outdoors and in their orchestra. In collections such as these, the rich visual and print material at the Medical Historical Library captures the labor required to carry out medical research and care, as well as the correspondence networks of medical professionals using medicine to respond to crises of labor. Left: Jiemin Tina Wei is a PhD candidate in Harvard University’s Department of the History of Science. Her dissertation and book in progress, “Ameliorating Fatigue at Work: Workplace-Management, Mind-Body Medicine, and Self-Help for Industrial Fatigue in the U.S., 1900-1950,” investigates the history of attempts to ameliorate workplace fatigue in the first half of the twentieth century. This research has been generously supported by the Ferenc Gyorgyey/Stanley Simbonis YSM’57 Research Travel Grant, and by the wonderful staff at the Medical Historical Library in the Harvey Cushing/John Hay Whitney Medical Library at Yale University, especially Melissa Grafe, Chris Zollo, Kathi Isham, and Christine Bailey.  

Access to the Cushing Center is Changing

December 19, 2023 - 1:46pm by John Gallagher

As part of a larger reimagining of the Cushing Center, we’d like to share our new mission statement: The mission of the Cushing Center is to inspire wonder about the human brain and its disorders, to educate visitors about the history of modern neurosurgery, and to respectfully steward the remains of patients contained within the Cushing Brain Tumor Registry. The Cushing Center will be closed January 8-9, 2024. Starting January 10, 2024 access will change:  Yale students, faculty, and staff may request swipe access to the Cushing Center by registering on this Qualtrics form. Please allow 2 business days for your request to be processed. YNHH employees must register on this Qualtrics form and pick up a pass at the circulation desk. Members of the public are invited to visit the Cushing Center by guided tour only. Tours are available Fridays at 10am and 2pm and by request.   During your visit, please demonstrate respect for the patients and the specimens on display. Photography is not permitted.

Patent Medicines, Medicine Shows, and The Secret Life of Blackface

October 12, 2023 - 3:04pm by Melissa Grafe

Written by Michael Ortiz-Castro, Harvard University Ferenc Gyorgyey/Stanley Simbonis YSM’57 Research Travel Grant recipient, 2023-2024 Medicine shows were grand spectacles—among some of the first large scale, public, and free theatrical venues in the United States. The spectacles were incredibly popular in the U.S., particularly in the South and the West, from the 1870s to about the 1930s, when they were displaced by films and moving images. These shoes were designed to sell patent medicines—tonics, tinctures, and creams akin to today’s “As Seen on TV” medicines. These medications were popular throughout this era, until increased regulation in the early 20th century led to the development of properly vetted medications. Medicine shows, in their attempts to sell to customers, borrowed theatrical elements from other genres such as vaudeville and, significantly, minstrel shows. While historians of medicine who write on the history of these spectacles have noted the show’s problematic usage of images of Native peoples, not many have talked about the usage of blackface elements.[1] The collections at the Medical Historical Library in the Harvey Cushing/John Hay Whitney Medical Library help historians further interrogate the usage of images of the Other in these shows, and, as I argue in my dissertation, help understand how medicine shows “performed” American identity through their linking of race, prosperity, and health. The 1930 film “The Medicine Man” tells the story of Dr. John Harvey, a traveling salesman who lands in a nameless American town and falls in love with young Mamie, who is abused, along with her siblings, by their domineering German father.  Harvey’s traveling circus attracts the attention of Young Mamie, and the film details their romance and his rescue of Mamie from her father’s plans to marry her off to a rich older German.[2] [3] The movie’s plot is lifted from the traveling show of the same name, which was used to market Pawnee Pepto—a patent medicine that promised to cure all kinds of ailments in its consumers. While the film spends more time on the romance between Dr. Harvey and young Mamie, an informed viewer will see vestiges of the original source within the film—a short scene of Harvey’s presentation in the town, and other characters’ acknowledgement of the impressive “Indian” traveling with him. Consider the film’s official movie poster, which features Jack Benny in the titular role front and center. He is flanked by a motley crew of characters—two women in Hawaiian inspired costume, a man dressed as the devil, and the “Indian”. The film poster, however, when juxtaposed with a shot of the live medicine show, reveals a critical occlusion: a blackface character, who flanks Dr. Harvey on the stage. From the scant archival record, it’s hard to say what role these characters played in the medicine show. Scholars who write on medicine shows have claimed that Native characters associated with patent medicines often served as “verification”—as symbols of unvarnished nature that could speak to the efficacy and “healthiness” of the medicine.[4] What role, then, might have the blackface character have played? Historians of the minstrel genre note that blackface characters allowed white Americans to both reinforce their racist perceptions while also allowing a comical outlet for anxieties and fears over difference and equality (given that minstrel shows became incredibly popular following the Civil War).[5] Positioned alongside the Native figure, the audience might have read the blackface character as “verifying” much like the Native chief. But what did this figure verify? Consider the context of the photo of the live show. The shot captures the climax moment—where Dr. Harvey convinces the young protagonist to run away with him. The characters flank him, like ghosts, reminding the viewer of all the medicine has given him: good health, good morality, and good prosperity. The selling point of the patent medicine was not just that it was good for you—but it could deliver proper health, proper morality, and wealth, the hallmarks of the American “good life”. Other ephemera from the Medical Historical Library’s collections allow us to see how blackface/minstrel characters figured into the cultural life of patent medicines. These advertisements for patent medicines used blackface characters to appeal to white customers’ ideas of domesticity and health. The first ad, for Beecham’s Pills, depicts a black domestic worker, jovially dancing as she holds a small tincture box. The ad’s caption—“What Am Good For De Missus Am Good For Me”—is the ad’s selling point: the black woman’s recognition of the medicine’s value, in her role as the caretaker of the home (the “Mammy” figure), is how the customer comes to understand the value and efficacy of the medicine. Though, as historians have noted, Native peoples were used as symbols of nature that could “verify” the medicine, the deployment of Black bodies as imagery here instead relies on the peculiar domestic relations developed in slavery. That is repeated in the ad on the right, where the prosperous consumer is quite literally “fed” the medicine (here, Sanford’s Ginger) by his stereotypically depicted black servant. The customer’s trust in the medicine comes from the relationship between the white character and his black servant –the servant’s duty and joviality ensure the viewer that the medicine is, indeed, reliable—like the enslaved. These images suggest that patent medicines, medicine shows, and their associated visual ephemera are best understood not merely as deceptive medical ads, but as cultural forms that, like minstrel shows and vaudeville shows, served to make clear certain cultural ideologies of difference and health operative in late 19th century U.S. Patent medicines were attractive as objects precisely because they spoke to some of the major anxieties at play: economic security, good health, and prosperity to come. Though medicine shows remain undertheorized among historians of medicine, these collections allow us to begin to uncover the genre’s relation to other problematic cultural productions active during the era. [1] Tomes, Nancy. 2005. “The Great American Medicine Show Revisited.” Bulletin of the History of Medicine 79 (4): 627-63. https://doi.org/10.1353/bhm.2005.0173.; Armitage, Kevin C. 2003. “Commercial Indians: Authenticity, Nature, and Industrial Capitalism in Advertising at the Turn of the Twentieth Century.” The Michigan Historical Review 29 (2): 70–95. https://doi.org/10.2307/20174034.; Price, Jason. 2011. “'The Best Remedy Ever Offered to the Public': Representation and Resistance in the American Medicine Show.” Popular Entertainment Studies 2 (2): 21–34. [2] The Medicine Man, Directed by Scott Pembroke (Tiffany Pictures, 1930). [3] While the record trail is scant on the medicine show from which the movie derived, historian Irina Podgorny’s “‘Please, Come In’: Being a Charlatan, or the Question of Trustworthy Knowledge” speaks of the show as separate from the film, which implies the existence of the show prior to the movie. [4] Armitage, “Commercial Indians”. [5]“Blackface: The Birth of an American Stereotype.” National Museum of African American History and Culture, November 22, 2017. https://nmaahc.si.edu/explore/stories/blackface-birth-american-stereotype.        

New Exhibition Celebrates 100 Years of Yale School of Nursing

August 24, 2023 - 9:57am by Janene Batten

Yale School of Nursing Centennial (1923 - 2023) On view in the Cushing Rotunda August 18, 2023 - January 14, 2024 Please join us for our newest exhibition celebrating 100 years of the Yale School of Nursing. The core mission of Yale School of Nursing (YSN) is “better health for all people.” As we celebrate YSN's 100th anniversary, we take this opportunity to explore and reflect on the school’s first century. Highlights of this exhibition include the assessment that helped found YSN as a completely new model of nursing education; the immense growth and change across the student population and faculty; the innovative methods of pedagogy and research inside and outside the classroom; a long tradition of community and global service; and a glimpse of the school today. Curated by Janene Batten, Ed.D., MLS; Courtney Brombosz, MLS; and Melissa Grafe, Ph.D. View the full schedule of centennial celebrations on the YSN website.

An Intern’s Journey Through History: Extending the Past for the Future

August 17, 2023 - 9:01am by Melissa Grafe

Article by Blake Spencer – July 7, 2023 At Yale University’s Center for Preservation and Conservation, there is an air of care and fastidiousness when dealing with materials that hold irreplaceable value to multiple audiences. From arabesque covers bearing allegories relating to metaphysics to the material world of important information detailed within those covers, there is more to each item than the exterior presents at first glance. These collections carry the practical usage of research, knowledge, and spiritual life within each page. These materials deteriorate over time, whether the cause is through specific external agents of deterioration or because of internal vice, such as the acidity of the paper. As a student interning at Yale University through the HBCU Library Alliance, I learned about preservation and conservation methods used to care for multiple items in need of urgent intervention. This includes interleaving, rehousing, and other basic preservation skills I plan on taking back to my workplace, Moorland-Spingarn Research Center at Howard University. For my project I helped with processing and stabilizing the Michael L. Charney papers. Some of the documents being processed within this collection include: The Black Panther Newsletter Students for a Democratic Society pamphlets New Haven Mayday Newsletter One of the most intriguing parts of the collection had to be the pamphlets and newsletters relating to the New Haven Mayday protest, a rally that officially kicked off on May 1st, 1970 against the incarceration of the 9 Black Panthers charged for the death of Alex Rackley in Connecticut. At the height of COINTELPRO, a string of illegal surveillance and disruptive operations against recalcitrant American political organizations, FBI spies within subversive spaces were a common occurrence. Alex Rackley, a 19-year-old Black Panther Party member, was tortured and killed after being suspected as an informant for the FBI. With the Chairman of the Black Panther party, Bobby Seale, giving a speech the same day as Rackley’s murder, Seale – along with eight other members of the Panthers – were indicted. The imprisonment of the New Haven 9 served as the impetus for one of the most well-known trial protests in the United States, and organizations such as the Yale Strike News that published an informational newspaper relating to the Black Panther Party throughout the days leading up to the May Day protest. With seething tensions bubbling amongst Yale’s students and teaching faculty throughout the campus, demands presented by Yale’s Strike Steering Committee were placed at the administration’s doorstep. These demands not only called for Yale to make a statement demanding the "state of Connecticut end the injustice of the trial of Bobby Seale and the New Haven Panthers” but to provide support to New Haven residents with material change, such as creating the Calvin Hill Day Care Center by 1970 and allocating $5 million dollars for immediate construction of 2000 units for low and moderate income housing. The Michael L. Charney collection also holds various records from organizations dealing with the grievances shared by many medical students and medical professionals across the country, one of the most prevalent being the Medical Committee for Human Rights. One of the pamphlets I came across while processing was titled “Health Radicals: Crusade to Shift Medical Power to the People." This pamphlet talks about how MCHR as an organization has evolved into the “voice of the humanist medicine,” carrying out the “staffing (of) community-controlled free clinics to pushing back against established health-care institutions.” The MCHR developed its ideologies alongside the civil rights movement in the 1960s, including fighting for the “demystification of the medical art” and the “direct control of health institutions by health workers and the people they serve.” While working with Archivist Kathi Isham and Conservator Laura O’Brien Miller on the Michael L. Charney papers, I engaged with Charney’s work as a medical student while learning more about the processes that go into preservation. Learning how to make object mounts for exhibitions that hold these manuscripts, how to make items more accessible through photo digitization, and housing materials in protective, archival enclosures for safe handling and to extend the life of documents have been very gratifying experiences, making the arduous task of preservation worthwhile. Special thanks to Laura O’Brien-Miller and Kathi Isham, my project supervisors during my internship, and to the HBCU Library Alliance for this opportunity.  

Sketchy Medical – New Resource Alert!

August 14, 2023 - 1:56pm by Elizabeth Jenkins

The Medical Library is happy to announce that we have licensed Sketchy Medical for the upcoming academic year. To access, click "Continue with your school" and select Yale. This popular resource received a 90% student satisfaction rate on the LCME Independent Student Analysis Report and ranked the highest of the online learning materials for medical education!  Sketchy Medical’s creative videos support the learning and retention of complex medical concepts. The platform also includes 1040+ interactive flashcards and 4860+ quiz questions to help students prep for the USLME Step 1 and 2 exams.   Board prep materials are a popular and vital resource for students but were not traditionally funded by the library prior to the covid-19 pandemic. The Medical Library is collaborating with the School of Medicine to review options and identify resources to support student learning in this area. Sketchy Medical be licensed for a one-year pilot, as part of an ongoing review of library-supported board prep materials.    

New Resources!

August 3, 2023 - 11:39am by Elizabeth Jenkins

The Medical Library recently added dozens of new resources to our collections as well as upgraded access to some existing ones. Highlights include: ERIC and Agricola are now searchable via the OVID interface, which maximizes advanced search capabilities. New modules are available in Aquifer (Clinical Excellence, Family Medicine, Geriatrics, Internal Medicine, Integrated Illness Scripts, and Neurology) and faculty may now use Aquifer content in the classroom. A new subscription to TRIP Pro which supports evidence based medicine (EBM) by providing a snapshot of the current research on a clinical topic. Search results are color coded based on the EBM pyramid, making it easy to identify the quality of the evidence. Expanded access to McGraw Hill modules including AccessAPN, AccessCardiology, AccessDermatologyDxRx, AccessHemOnc, Access Neurology, and the Case Files Collection. New Sketchy license View the full list of new resources below. New Databases 5Minute Consult is a point-of-care tool developed for clinicians to quickly find evidence-based answers to support the diagnosis, treatment, and ongoing care of patients with 2,000 common diseases/conditions, drugs, and diagnostic and treatment algorithms AccessPharmacy supports teaching and learning in pharmacy education, including key pharmacy textbooks, drug monographs, drug flashcards, practice tests, and other multimedia content Agricola is a curated database of agricultural literature from the USDA National Agricultural Library. It is now searchable via the OVID interface to maximize advanced search capabilities. Aquifer provides medical students with interactive patient cases to support the learning in clinical clerkships. The library upgraded our subscription and became a Curricular Partner. This provides faculty with the flexibility to use Aquifer content in the classroom and access to the following new modules Clinical Excellence, Family Medicine, Geriatrics, Internal Medicine, Integrated Illness Scripts, and Neurology. ERIC or the Education Resources Information Center, is an online database of education research and literature. It is now searchable via the OVID interface to maximize advanced search capabilities. Health Care Administration Database includes citations relating to hospital administration, insurance, law, statistics, business management, personnel management ethics, health economics, and public health administration. JAMA Evidence provides resources to help students and clinicians translate the theory of evidence-based medicine (EBM) into practice. Includes textbooks, tools, and forms to make decisions including validity, importance and applicability of claims. TRIP Pro supports evidence-based medicine (EBM) by providing a snapshot of the current research evidence on a clinical topic. Content in Trip Pro includes clinical guidelines, systematic reviews, regulatory guidance, randomized controlled trials and more. Search results are color coded based on the EBM pyramid, making it easy to identify the quality of the evidence.   New Journals  The AASLD Collection is a package of journals from the American Association for the Study of Liver Diseases. Titles include Hepatology, Clinical Liver Disease, Liver Transplantation, and Hepatology Communications. The AJOB Package includes access to the American Journal of Bioethics, AJOB Empirical Bioethics, AJOB Primary Research, and AJOB Neuroscience. These journals focus on addressing ethical challenges in health science. The Journal of the American Society of Nephrology (JASN) and the Clinical Journal of the American Society of Nephrology (CJASN) are both peer reviewed journals that discuss topics related to the kidneys and nephrology. NEJM Evidence is a new peer-reviewed journal published by the NEJM Group aimed at the evaluation of clinical research. Articles focus on validating existing clinical findings, improving the design of new clinical trials, and contextualizing clinical evidence. Reaching Teens: Strength-Based, Trauma-Sensitive, Resilience-Building Communication Strategies Rooted in Positive Youth Development is a digital toolkit, developed by the American Academy of Pediatrics, to support clinicians in effectively engaging with teenagers. Specialized Resources Partek Flow software is used to analyze RNA, small RNA and DNA sequencing. It allows for users to develop analysis pipelines and data visualizations. Due to popularity, the library purchased an additional software license. New Journal Backfiles The American Journal of Gastroenterology is published by the American College of Gastroenterology and is one of the leading journals on gastroenterology and hepatology. We now have backfiles back to 1998. The Medical Clinics of North America, is published bimonthly, each issue of this peer-reviewed journal focuses on a specific medical topic and contributions are provided from leading experts in the related field. AASLD Backfile includes archived content of the American Association for the Study of Liver Diseases journals.    

New Exhibition: This Lead Is Killing Us

July 6, 2023 - 2:55pm by Megan Nance

The Medical Library is pleased to annouce a new banner exhibition "This Lead Is Killing Us: A History of Citizens Fighting Lead Poisoning in their Communities" produced by the National Library of Medicine. The exhibition is on view in the corridor between SHM L 112A/B from July 3 - August 12, 2023. "This Lead Is Killing Us" explores the story of citizen action taken against an environmental danger. Lead exposure can cause neurological problems and sometimes even death; yet this metal has been pervasive in many aspects of American life for over a century. Historically, mining, battery manufacturing, smelting, and enameling industries included lead in their production processes, impacting factory workers and consumers. Manufacturers added lead to household paints and gasoline, endangering the health of families and polluting the air through exhaust fumes. To protect themselves against the dangers of lead poisoning, scientists, families, and individuals opposed industries, housing authorities, and elected officials. This Lead is Killing Us companion website includes an education component featuring a K-12 lesson plan that challenges students to examine historical cases of lead poisoning through primary and secondary sources. A digital gallery features a curated selection of fully digitized items from NLM Digital Collections that showcase numerous historical scientific studies and reports about the dangers of lead. The National Library of Medicine produced this exhibition and companion website. Image: During the 1960s and 1970s, environmental movements led to increased governmental action, including publications that warned parents of lead in homes. Lead Paint Poisoning in Children...a Problem in Your Community? U.S. Dept. of Health, Education, and Welfare, 1973. Courtesy National Library of Medicine.  

Access to American Hospital Association (AHA) Data

July 3, 2023 - 10:22am by Kaitlin Throgmorton

Access to American Hospital Association (AHA) Data After years of requests for American Hospital Association (AHA) data, the Medical and Marx libraries at Yale have made access to this important U.S. hospital data available for all Yale affiliates. Containing multiple decades of annual survey and supplemental datasets, this data resource provides information about U.S. hospitals' organizational structure, service lines, utilization, finances, insurance and payment models, and staffing, enabling peer comparisons, market analysis, and health services research. To access AHA data, create an account on the platform, Wharton Research Data Services (WRDS), with your yale.edu email address. To learn more about how to get started, consult this research guide. If you already have a WRDS account, access AHA data now. Quick facts about AHA Data: 40+ years annual hospital survey data, dating back to 1980 1,000+ data points about U.S. hospitals for each survey year In addition to survey results, additional hospital data has been curated by AHA, including data and information from government sources, hospital accrediting bodies, and other organizations as well as AHA's financial database Beyond the data itself, WRDS features include a query builder, manuals, data dictionaries, documentation, and more to facilitate data use  
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